What are the responsibilities and job description for the Insurance Claims Specialist position at NEW Community Clinic LTD?
The Billing Specialist is a key member of N.E.W. Community Clinic (NEWCC) responsible for the organization's operational excellence. They manage the full array of services and programs provided by the organization to advance the mission and vision. NEWCC has a unique mission of ensuring access for underserved, under-insured and uninsured patients regardless of the inability to pay.
The Billing Specialist is responsible for ensuring accurate and timely billing of healthcare services as well as following up on outstanding insurance claims and payor contracts. This role involves interacting with patients, insurance companies and internal departments to ensure timely payment of claims, resolve billing issues and ensure a positive patient experience. A personable demeanor, attention to detail, & patience is needed to ensure that the accounting department supports NEWCC in serving the uninsured and underserved in Brown County.
- Manage and process insurance claims, ensuring accuracy and compliance with industry standards
- Review and analyze patient records to ensure accurate coding of procedures and diagnoses
- Monitor and follow up on outstanding claims to facilitate prompt reimbursement contact insurance companies to resolve billing issues, denials, and discrepancies; submit appeals when necessary
- Collaborate and document processes and workflows to help streamline and create efficiencies to help with complex billing, coding, and payer issues
- Accounts receivable: collect cash receipts from clinics and ensure funds are substantiated
- Work insurance claims denial management
- Verification of benefits for medical and behavioral health before patient is seen
- Gathering Medicaid wrap reports and sending to CFO
Qualifications:
- High school diploma required, Associate's degree preferred
- Experience with EPIC/EPIC Wisdom preferred
- Experience with medical billing/insurance preferred
- Understanding of FAQH billing procedures and Sliding Fee schedules a plus
If you are someone who is passionate about your community and helping those within it, then come join our amazing team!